Last month, the Department of Health and Human Services and the Drug Enforcement Administration (DEA) jointly released guidance on telemedicine and the prescribing of opioids for treatment of opioid use disorder. The National Council has long been advocating for changes to be made to DEA regulations restricting how behavioral health medications that are controlled substances can be prescribed via telemedicine. While the guidance is meant to promote the use of telemedicine during the opioid crisis, it offers little “new” information and instead reiterates what is and is not permitted under current law.

Under current regulations, some community mental health and addiction treatment centers are ineligible to register with the DEA so as to offer patients access to prescriptions that are controlled substances via telemedicine. Changing this restriction, as the National Council has been advocating, would require DEA to permit community mental health and addiction treatment centers to register with the agency to provide controlled substances, such as MAT medications and certain psychiatric medications, per the terms of the Ryan Haight Act.

Included in the guidance is a clinical case study highlighting a scenario in which a patient may lawfully access a prescription for controlled substance via telemedicine. In the scenario that was provided, a patient could receive a buprenorphine prescription from a DATA-2000 waivered prescriber when the patient is in the physical presence of a DEA-registered nurse, even if that nurse does not have a DATA-2000 waiver to prescribe buprenorphine. While important, the guidance does not provide an example of how teleprescribing might work in situation in which a patient is not in the presence of a DEA-registered practitioner nor are they located in a DEA-registered clinic.

OPPORTUNITY MOVING FORWARD

Included in Congress’ legislative opioid package – on track to be signed into law later this year – was a provision directing DEA to enact a special registration for telemedicine prescribing. The National Council will continue working closely with DEA on developing a registration pathway to be more inclusive of community mental health and addiction treatment providers across the country.